What is a Tissue Expander | Breast Reconstruction Overview

[MUSIC]
00:08
If the best option for you is a staged reconstruction,
00:11
you will most likely receive a temporary tissue expander
00:15
at the time of your mastectomy.
00:17
During mastectomy, the surgeon creates a pocket,
00:20
generally behind the chest muscle where a temporary tissue
00:23
expander may be placed.
00:24
At the time of surgery,
00:25
the surgeon will insert small surgical drains for
00:27
your body's natural healing fluid.
00:30
Through a port located inside the expander,
00:32
the team will periodically inject saltwater solution
00:35
to fill the expander over a few months.
00:38
The expander gradually stretches the muscle and
00:40
skin in preparation for
00:41
either an implant or tissue reconstruction.
00:45
After the skin over the breast area has stretched
00:47
to the appropriate size,
00:48
the expander will be removed in a second operation and
00:51
the final reconstruction will be performed.
00:55
Most often, we place a sheet of collagen,
00:57
a material that is natural in your body as reinforcement for
01:01
the tissue expander.
01:02
This is called an acellular dermal collagen matrix in which
01:06
blood vessels grow in over time becoming a part of you.
01:11
This provides an internal bra of sorts or a sling to support your
01:16
reconstruction by preserving the fold under the breast.
01:20
The whole process can take weeks to months and is different for
01:24
each individual, depending on whether treatment such as
01:27
chemotherapy or radiation therapy are required.
01:30
The tissue expander is always temporary,
01:33
hospitalization is usually overnight.
01:37
And women are usually back to work within two to four weeks,
01:40
depending on the type of job.
01:42
There is some discomfort with the expansion process,
01:46
because it is stretching the chest muscle,
01:48
but most women find that it is most sore in the first couple
01:52
of weeks improving over time and is overall very well tolerated.
01:57
The drains will remain in for one to two weeks.
02:00
At Johns Hopkins,
02:01
your experienced breast reconstruction team will do
02:04
everything possible to make your breasts look and feel as natural
02:08
as possible and will be able to answer any of the questions or
02:11
concerns at any time throughout your treatment.